Department of Internal Medicine, Wayne State University, School of Medicine, Detroit, MI, USA; Ascension Michigan, Detroit, MI, USA.
Department of Internal Medicine, Wayne State University, School of Medicine, Detroit, MI, USA; Ascension Michigan, Detroit, MI, USA.
Blood Rev. 2021 May;47:100761. doi: 10.1016/j.blre.2020.100761. Epub 2020 Oct 8.
COVID-19 has become a pandemic in the United States and worldwide. COVID-19-induced coagulopathy (CIC) is commonly encountered at presentation manifested by considerable elevation of D-dimer and fibrin split products but with modest or no change in activated partial thromboplastin time and prothrombin time. CIC is a complex process that is distinctly different from conventional sepsis-induced coagulopathy. The cytokine storm induced by COVID-19 infection appears to be more severe in COVID-19, resulting in development of extensive micro- and macrovascular thrombosis and organ failure. Unlike conventional sepsis, anticoagulation plays a key role in the treatment of COVID-19, however without practice guidelines tailored to these patients. We propose a scoring system for COVID-19-coagulopathy (CIC Scoring) and stratification of patients for the purpose of anticoagulation therapy based on risk categories. The proposed scoring system and therapeutic guidelines are likely to undergo revisions in the future as new data become available in this evolving field.
新冠病毒已在美国和全球范围内大流行。新冠病毒诱导的凝血病（CIC）在临床上较为常见，表现为 D-二聚体和纤维蛋白降解产物显著升高，但活化部分凝血活酶时间和凝血酶原时间仅有适度改变或无改变。CIC 是一个复杂的过程，与传统的脓毒症诱导的凝血病明显不同。新冠病毒感染引起的细胞因子风暴似乎在新冠病毒中更为严重，导致广泛的微血管和大血管血栓形成和器官衰竭。与传统的脓毒症不同，抗凝治疗在新冠病毒的治疗中起着关键作用，但目前尚无针对这些患者的具体治疗指南。我们提出了一个新冠病毒-凝血病（CIC 评分）的评分系统，并根据风险类别对患者进行分层，以进行抗凝治疗。随着该领域新数据的出现，该评分系统和治疗指南可能会在未来进行修订。
